True and Sham Acupuncture Produced Similar Frequency of Ovulation and Improved LH to FSH Ratios in Women with Polycystic Ovary Syndrome

Pastore L et al, 2011 Jnl Clin Endocrinol Metab Aug online jc.2011-1126 The Journal of Clinical Endocrinology & Metabolism
A reduction in LH levels and an increase in ovulation frequency was found in PCOS women having acupuncture using either real needling or sham needling (which pricks rather than penetrates the acupuncture points in a manner similar to Japanese acupuncture). As we have seen in a couple of other studies reported on these pages, mild stimulation of acupuncture points without penetration is not an inert control. True acupuncture but not sham acupuncture reduced levels of testosterone and insulin in the women who ovulated.



Context: Acupuncture may represent a nonpharmaceutical treatment for women with polycystic ovary syndrome (PCOS), based on four studies.

Objective: The objective of the study was to determine whether true, as compared with sham, acupuncture normalizes pituitary gonadotropin hormones and increases ovulatory frequency in women with PCOS.

Design: This was a randomized, double-blind, sham-controlled clinical trial (5 month protocol).

Setting: The study was conducted in central Virginia.

Participants: Eighty-four reproductive-aged women completed the intervention. Eligibility required a PCOS diagnosis and no hormonal intervention 60 d before enrollment.

Interventions: Intervention included 12 sessions of true or sham acupuncture (Park sham device) for 8 wk.

Main Outcome Measures: Serum LH and FSH at baseline, after intervention, and 3 months later were measured. Ovulation was measured with weekly urine or blood samples.

Results: Both arms demonstrated a similar mean ovulation rate over the 5 months (0.37/month among n = 40 true acupuncture and 0.40/month among n = 44 sham participants, P = 0.6), similar LH to FSH ratio improvement (−0.5 and −0.8 true and sham, respectively, P < 0.04 after intervention vs. baseline) and a similar decline in LH over the 5-month protocol (P < 0.05). Neither arm experienced a change in FSH. There were seven pregnancies (no difference by intervention, P = 0.7). Lower fasting insulin and free testosterone were highly correlated with a higher ovulation rate within the true acupuncture group only (P = 0.03), controlling for prestudy menstrual frequency and body mass index.

Conclusion: We were unable to discern a difference between the true and sham acupuncture protocols for these women with PCOS, and both groups had a similar improvement in their LH/FSH ratio.